Surgical appliance



A ril 26, 1932 N. w. FILE SURGICAL APPLIANCE Filed April 28, 1931 ll ulgwtnnloz Mli'ile Patented Apr. 26, 1932 UNITED: TA

PATENT OFFICE.

" lemme. FILE, or nvircniauzae, vr'aemra suneioaii ArrLIANcn Applicationfiled April as,

This invention relates surgical appliances, and has for its object toprovide a combination of heemostat and ligator, the'latter beingdetachably and slidably mounted upon the haemostat in such manner as toipermit the combined device to be brought to the bleeding point by theuse ofon'e hand only,. the loop oftheligatureencompassing] the jaws'ofthe haemostat, and as the heemostat has been clamped upon the bleedingpointyto permit the loop to be shed from the nose: of the haemostataboutthe-bleeding vesselby sliding the ligator forwardly along thehaemostat'." The invention contemplates "as well a modeof operation inwhich the combined device is'applied to the point of-b'leeding'wby onehand asdescribed, and then Se'p arated and subsequently manipulated asseparate instruments in. th'e fholding" of the vesseland tying 'it01f..- a 1 a Another object of. theinvention; is to pr'o videa-ligatorhaving means adapting it to be.

structurally associated with a haemostatwhil'e closing the bleedingvessel, the hae'mos'tatacting as arguide for th loop of the ligature,

leading it tothe tying off point ofthle'vessel' Figure 1 is a a planview 'of the combined .ligatorland heemostat, parts being-broken warn" 1315 Figure iunderneathf plan View I "of crating jaws 5 and I6.perferablyformed with 1931.- serial 533,522. f

the combined instrument,' the handles of the haemosta't being omitted;Figure 3 is a side elevation partly in section' onan enlarged scaleshowing theworking ends of the haemostat and ligator and theslidingconnection betweenthe two instruments;and I Figure 4 isasection-taken alongthe line l iof Figure3p Referring now in detail totheseveral fig- 5 ures the numeral 1 represents a haemostat ofusualconstru'ction, that is to say, it comprises 7 a pair of-handles 2and?) pivoted scissors-like atan intermediate point-4 and having coopefinely'serrated meeting faces? between which the bleedin'gvessel isadapted to be clamped The handles are made o-f re-silient material, onebeing provided witharatchet lug 8 and the other with a hook lug 9engaging with the ratchet to retain thejaws of the haemost'at closedwith varying degreesof pressure. 7

Thehaemostat as above described is'convention'al'and is not a part ofthepresent invention"per:se,but onlyin novelcombination with the ligatorfiI I j I g The 'ligator comprises a shank l0 having az'bore-ll in itsforward portion opening on'ftop ofthe s1mnk.;atthe point indicated at 12in Figure 1', said borereceiving a ligaturelS-which protrudes-from anorifice 14: at the forward end of theligator. Rear- 'wardly of theopening 12,-the shankof the li'gator carries a slidablymounted cleat 15about which the :free-endof the ligature is adaptedto be wound andretained; The'cle'at.

15 is mountedon a carriage 16-havinga cylindrical borethrough which theposterior is portiontof the shank '10 extends. The car; 'ria-ge 1 6 onits 'lo'wer face isprovided with "3;,

guide pins 1'1 and l8 sliding in a groove-19 formed on the"under-sidebf' the shank" 10.

The groove is provided' at its basewitha leafspring 20 oritsequivalent'against'which a the'ends ofthe pinsilfand 18 bear; iSa'idOOwith a channeled guide 25, the side fl'ang'esr leaf spring imposes aresilient resistance to the movement of the carriage 16 and acts as abrake.

The carriage is provided with finger rings 21 and the rearward end ofthe shank 10 of the ligator is provided with a finger ring 22. Thelatter ring is preferably formed with a socket 23 receiving the end ofthe shank 10 and being secured thereto by a thumb screw 24. When thefinger ring 22 is removed, the end of the slot 19 is thus openedpermitting the carriagel6 with itsappurtenant parts to be removedfromftheiligatorto facilitate cleansing and sterilizing of theinstrument. an intermediate point the ligator is provided of whichareadapted to freely embrace one ofthe handles of the haemostat. Figure3" shows the ligator thus-mechanically associ ated with the handle 3 ofthe hamostat. The broken line representation of the channeled guide 25shows thatit is; slidable upon the haernostat and when it is in itsforward-most position, the forward end of the ligator is in the brokenline position shown in Figure 3 in whichposition the loop 26 of theligature is shed from the jaws of the haemostat around the stump of the.bleedingvessel. i 7

In operating the combinedappliance, the

Jigator is mounted upon the haeniostat with 1 the guide25 embracing ahandle of the haemosta't andthe loop oftheligature placed aboutthejawsofthe haemostat as shown in Figures 1,2and-3, The haemostatisthen brought to thepoint-of bleeding with the lig'ator mountedthereupon, only one of the surgeons hands beingemployed, leaving theother hand free for any other desired manipulation. The

V haemostat is clamped uponthe bleedingstump .and the ligator is thenslid forward on the haemostat to the dotted line @position so that theloop of the iligature becomes [removed .fronrtheghaemostatand surroundsthe bleed- ".in'g vessel below the point of application of theha'ernostatQ It isfassumed that the knot by which the'loop of theligature is formed is'a slip knot so; that by pulling the cleat 15rearwardly,- -th e ligature is drawn through the; ligator' tighteningtheloop about the point of bleeding. Thewligature may then be cut oftandthehaemostat released. In

the manipulationof-the appliance as above described, the hfaemostatserves as a guidefor guiding the loop'26 oftheligature to the point ofbleeding and aroundthe vessel which is to be tied off. It is 'notnecessary however, that the ligator should remain slidably attachedtojthje hzemostat during thetying- ,ofl'; operation.;.:If desired, assoon: as the bleeding gvessel hasbeenclamped, thetligator -:may,belifted from the haemostat and manipulated as a separate instrument,Ialthough in Whati I claim is:

In addition to the advantage of being able to approach the point ofbleeding with both instruments, using only one hand, and having thehaemostat act always as a guide for the loop of the ligature, theinstrument has the additional advantage of being easy to keep clean andsterile since the bore through the ligator is but little larger than thediameter of the ligature, practically preventing the entrance of bloodinto said bore. The ease with which the ligator may be removed from thehzemostat andthe removable relation of the cleat and carriage 16 tothe.shank 10 of the ligator permits the'several parts to be separatedfacilitating the cleansing of the same.

the details ofconstruction as described are merely by way of example andare not to be construed as limitative in theirybearing upon the-scopeofthe invention as claimed.

. 1. A ligator including a shank having the bore in the anterior partthereof opening in the end of :said ligator and laterally, rearwardly;of @said end, and a ,cleat slidably mountedupon said 'ligatorforreoeiving the free portion of a ligature passing through the bore ofsaid shank,'and fortautening said I 2'. Ligator'comprising a=shank, saidshank being formed with a bore inits anterior por. tion opening in theend ofsaidshankand let .erally, rearwardly of 'said'end,.means on saidshank adapting it to be detachably and slid- .ably mounted onahaemostat,a sliding'cleat on said shank for receivingthe free :portion of saidligature and tau'tening-the loop of said ligature, a sliding carriage onwhich said cleat is mounted, said shankand carriagebeing provided with;:inter-enga 'ng elements forpreventing rotation. of sai carriage.

3. Ligatoras claimed in claim 2, the shank being formed with 'a :grooveand, the sliding carriage being .p-rovided'with guiding-pins extendingintosaid groove, and a spring in said groove engaged by, said pins andactingas a brake forsaidcarriagei f 4 Ligator as claimed in claim 2;,saidshank 5.:

being formed with a groove'openinginto the posterior end of said shank,guiding pins extending from said carriage into said groove, a spring insaid-groove engaged by saidipins forming a brake for -said carriage, anda detachable handle on the end o f-said shank normally closing the openend of said groove, said carriage being removable from said shankthrough' the" open end of said; groove upon removal of said handle.

5 A ligatoradapted to be slidably andidetacha bl y secured to ahsemostat, including a channeled guide adapted to slip' over a1ongitudinal member of said haemostat, said-ligaitor comprising; a:shank having a bore in' the ago anterior part thereof opening in the endof said ligator and laterally at an intermediate point, and a eleatslidably mounted upon said ligator rearwardly of said lateral openingfor receiving the free portion of a ligature assing through the bore ofsaid shank, an for tautening said ligature.

6. Ligator as claimed in claim 2, the shank being formed with a grooveand the sliding carriage including a guiding portion extending into saidgroove, and aspring in said I groove engag ng sald guidlng portlon and Vacting as a brake for said carriage.

In testimony whereof I afiix my signature.

NORMAN W. FILE.

